| Objective To evaluate the impact of GC on the risk of fracture in rheumatisants by using the fracture risk assessment tool (FRAX) adjusted by Glucocorticoid (GC). Methods 180 patients with rheumatism who had been treated in the Fourth medical centre of PLA General Hospital from January 2019 to January 2020 and 180 healthy people in the same period were enrolled, all of them were measured for bone mineral density tests at hip and lumbar spine. All patients with rheumatism were systematically treated with GC for more than 3 months. According to the daily average dose of GC, they were divided into GC ≤7.5 mg group, 7.5 mg < GC < 30 mg group and ≥30 mg group. Then 10 year probability of hip fracture (PHF) and major osteoporotic fracture (PMOF) was calculated by FRAX of Chinese model. For people receiving GC dose of >7.5 mg/d, the fracture risk calculated with FRAX should be adjusted. All results between the groups were compared. Results ① PMOF and PHF in GC use group were higher than those in healthy control group, and the difference was statistically significant (P＜0.05); ② According to the duration of GC usage, they were divided into > 2 years group and ≤ 2 years group, and the PMOF and PHF in GC use > 2 year group were higher than ≤ 2 years group, the difference was statistically significant; ③ PMOF and PHF in GC ≤ 7.5 mg group before FRAX adjusted were higher than those in other two groups, and the difference was statistically significant; ④ PMOF and PHF in GC ≤ 7.5 mg group after FRAX adjusted were still higher than those in other two groups, and the difference was statistically significant compared with GC ≥ 30 mg group; ⑤ According to the osteoporosis intervention threshold of PMOF 20 % and PHF 3 %, the patients who reached the treatment threshold were 0 and 9 (5 %) respectively; according to the intervention threshold of PMOF 10 % and PHF 1 % which were recommended by GIOP in 2017, the number of patients who reached were 8 (4.44 %) and 41 (22.78 %) respectively. Conclusion After GC adjusted, the fracture risk of rheumatism patients who received GC treatment evaluated based on FRAX can be increased, and the number of people who have reached the threshold of osteoporosis intervention also increase, which can more effectively predict the fracture probability of rheumatism patients using GC, and proper anti-osteoporosis treatment should be performed for these patients to reduce the probability of fracture. |